【摘要】 目的:比较血清前列腺特异抗原(t-PSA)、游离前列腺特异抗原(f-PSA)诊断前列腺癌(PCa)和全身骨显像对PCa骨转移的诊断效能,探讨PSA检测联合全身骨显像诊断PCa的临床价值。方法:回顾性分析33例PCa患者和14例前列腺增生(BPH)患者的血清t-PSA、f-PSA和全身骨显像结果,以病理诊断或临床随访为确诊标准,骨显像结果依照5分法评分(0分:骨显像正常;1分:骨良性病变可能性大;2分:不确定;3分:骨转移可能性大;4分:骨转移明确)。比较t-PSA、f-PSA和全身骨显像的ROC曲线下面积和最佳域值点的诊断灵敏度和特异性。结果:t-PSA、f-PSA和全身骨显像的ROC曲线下面积分别为0.686、0.637和0.948,最佳域值点的诊断灵敏度和特异性分别为57.6%、78.6%;84.8%、42.9%,90.0%、82.6%。结论:血清PSA检测联合骨显像可有效地诊断PCa,排除高PSA水平良性病例,避免不必要的创伤检查。更多还原

【Abstract】 Objective To compare the clinical efficiency of serum total prostate specific antigen(t-PSA) and free-PSA(f-PSA) for prostatic cancer and99mTc-MDP bone scintigraphy(BS) for bone metastasis.To explore the diagnostic value of PSA combined with BS in diagnosing prostatic cancer.Methods To analysed retrospectively on serum PSA levels were measured in 33 patients of prostatic cancer and 14 patients of prostatic hyperplasia who all underwent99mTc-MDP BS.BS images were interpreted according to 5-point scale(0:definitely negative,1:propably negative,2:equivocal,3:propably positive,4:definitely positive for bone metastasis).ROC analysis was performed.Results The area under the ROC curve of t-PSA,f-PSA and BS were 0.686,0.637 and 0.948 respectively.The diag-nostic sensitivity and specificity of the best domain value points were 57.6%,78.6%; 84.8%,42.9%; 90%,82.6% individually.Conclusion PSA combined with99mTc-MDP BS could diagnose prostatic cancer effectively and exclude the benign cases with high PSA levels,avoid unnecessary traumatic examination.更多还原